CEPR Health-insurance Coverage for Low-wage Workers, 1979-2010 and Beyond
This paper uses data from the Current Population Surveys for 1980 through 2011 to review trendsin health-insurance coverage rates for low-wage workers (defined as workers in the bottom fifth of the wage distribution in each survey year). In 2010, over 38 percent of low-wage workers lackedhealth insurance from any source, up from 16 percent in 1979. The biggest reason for the decline incoverage is the erosion of employer-provided health insurance, either through a worker
s ownemployer or as a dependent on another family member
s employer-provided policy. Over the lastthree decades, the role of public insurance in providing coverage for low-wage workers hasincreased, though not nearly enough to offset the declines in private insurance. In 2010, about 10percent of low-wage workers had coverage through Medicaid, double the share in 1979. While agreat deal of uncertainty still surrounds the Affordable Care Act (ACA) and its likely impact onemployers and workers, reasonable estimates based on consensus projections suggest that the ACA will have a substantial positive effect on health-insurance coverage rates for low-wage workers. Evenso, the ACA will likely leave an important share of low-wage workers, especially low-wage Latino, African American, and Asian workers, as well as many immigrant workers, without coverage. At thesame time, if the ACA is blocked
in the courts or in Congress
there is every indication thatcoverage rates for low-wage workers will continue their long, steady decline.